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Exposure to PM2.5 and respiratory health among traffic policemen in Kuala Lumpur

Ahmad Syazrin Muhammad, Juliana Jalaludin, NurAqilah M. Yusof

Journal of Occupational Safety and Health, 2012;9(3):55-64.
MyJurnal

Exposure to traffic air pollutant have shown a significant health effect on respiratory systems and decreased in lung function among traffic policemen. The main objective of this study was to determine the relationships between personal exposure levels to PM2.5 and respiratory health among traffic policemen working at Traffic Police Station in Kuala Lumpur and general duty policemen attached to Police Headquarters, Bukit Aman. A cross sectional comparative study was conducted among 50 traffic policemen from Traffic Police Station Kuala Lumpur and 50 general duty policemen from Police Headquarters Bukit Aman as comparative group. A purposive sampling method was used to select the respondents based on inclusive criteria such as age between 25 to 60 years, no history of respiratory disease and working not less than 3 years as traffic policemen. Questionnaire based on ATS (1978) was used to collect information on socio-demographic and respiratory symptoms. Spirometer (Spirolab II Model) was used to perform lung function tests. Personal Air Sampling Pump (Aircheck 52) was used to measure personal exposure level to PM2.5. The mean exposure level of PM2.5 among the traffic policemen was 22.33 ± 8.54μg/m³ compared to only 5.60 ± 4.29μg/m³ for comparative group. There was a significant difference in all lung function parameters between the exposed group and comparative group.From the finding, it shows that there was significant relationship between working duration (years) and lung function parameters among both exposed and comparative group. The result from this research shows that traffic policemen were determined as having lower lung function parameters due to their nature of work and the environment. Also, there was a significant association between exposure to fine particle (PM2.5) and lung function among the exposed group. Finding from this study indicated that exposure to elevated concentration level to traffic related air pollutant was the risk factors in the development of respiratory diseases as shown by the higher prevalence of respiratory symptoms and the reduction in lung function among traffic policemen.

Matched MeSH terms: Respiratory System
Fulltext Cytomegalovirus infection associated with Atypical Bronchopulmonary Dysplasia in a Preterm Neonate: a case report

Aisha Fadhilah Abang Abdullah, Zurina Zainudin, Dg. Zuraini Sahadan

Malaysian Journal of Medicine and Health Sciences, 2018;14(2):97-99.
MyJurnal

Cytomegalovirus (CMV) is frequently isolated from neonates. Symptomatic infection is only apparent in 10% of affected babies with particular predilection for the reticuloendothelial and central nervous system. Isolated respiratory system involvement is rarely encountered. We report a case of a premature 32 weeks infant who required prolonged oxygen dependency and treated for bronchopulmonary dysplasia. The diagnosis of CMV pneumonitis was only discovered after detection of CMV DNA in the bronchoalveolar lavage. A high level of clinical awareness is crucial as a definite diagnosis and treatment will significantly alter the morbidity and the cost of therapy.

Matched MeSH terms: Respiratory System
Fulltext Investigation of the natural supplement IQP-AS-119 for the prevention of upper respiratory tract infections in marathon race participants: A randomized, double-blind, placebo-controlled pilot study

Bongartz U, Hochmann U, Pohl U, Bothe G, Costa P, Chong PW, et al.

Exp Ther Med, 2021 Feb;21(2):144.
PMID: 33456511 DOI: 10.3892/etm.2020.9575

Intense and prolonged exercise leads to immune suppression, causing upper respiratory tract infections (URTI). A proprietary standardized dietary supplement, IQP-AS-119 has been previously developed to aid immune responses under such conditions. The current randomized, double-blind, placebo-controlled pilot study aimed to investigate the effects of IQP-AS-119 on marathon runners. A total of 80 participants were randomized equally into groups receiving either placebo (P group) or IQP-AS-119 (V group) treatment, starting 3 weeks before and for 14 days after the marathon. Benefit assessment was performed using different questionnaires. Post-marathon, the V and P groups reported 1±2.38 and 2.11±3.25 days with upper respiratory tract symptoms (URTS), respectively (P=0.038). During the 14 days post-marathon, 20.0% of the participants in the V group compared with 44.4% in the P group reported URTS (P=0.042). The V group reported significantly milder URTS compared with the P group on Days 9, 12, 13 and 14 post-marathon (P<0.05). The total Perceived Stress Questionnaire-20 score on days 2-14 were significantly lower for the V group compared with the P group (P=0.035). In the Short Form 12 Health Survey, the V group exhibited significant improvement in mental composite score on days -5 to 14 compared with the P group (P=0.038). In the overall treatment effect assessment, there were no statistically significant differences between the groups. The IQP-AS-119 was rated 'very good' or 'good' by investigators and participants, respectively, for 71 and 65% of the participants. The tolerability of IQP-AS-119 was rated as 'very good' or 'good' by both investigators and 95% of participants. No clinically relevant differences were observed between groups regarding adverse events or other safety parameters. Therefore, IQP-AS-119 was demonstrated to reduce the incidence and severity of URTI in marathon runners. Given its good tolerability profile, IQP-AS-119 may be a good nutritional supplement for the reduction of URTS in susceptible individuals.

Matched MeSH terms: Respiratory System
Fulltext Upper respiratory tract symptoms, renal involvement and vasculitis: a case report and review of wegener granulomatosis

Said MS

J Clin Med Res, 2010 Aug 18;2(4):189-93.
PMID: 21629538 DOI: 10.4021/jocmr412w

Wegeners Granulomatosis is a condition associated with systemic vasculitis which can present with upper respiratory tract symptoms initially. On September 2001, a 15-year-old girl presented with symptoms of nasal block for 3 weeks. She later developed joint pains and worsening renal status requiring dialysis. A renal biopsy was performed which showed pauci-immune cresentric glomerulonephritis. Her cANCA levels were positive. She was treated with oral cyclophosphamide and steroids and later responded.
KEYWORDS: Wegener granulomatosis; Young girl; Cyclophophamide; cANCA.

Matched MeSH terms: Respiratory System
A scanning electron microscopic study of in vivo tissue engineered respiratory epithelium in sheep

Heikal MY, Aminuddin BS, Jeevanan J, Chen HC, Sharifah S, Ruszymah BH

Med J Malaysia, 2008 Jul;63 Suppl A:34.
PMID: 19024970

Normal tracheal mucociliary clearance is the key to maintaining the health and defense of respiratory airway. Therefore the present of cilia and mucous blanket are important for tracheal epithelium to function effectively. In the present study, we prepared a tissue engineered respiratory epithelium construct (TEREC) made of autologous respiratory epithelium cells, fibroblast and fibrin from sheep owns blood which replaced a created tracheal mucosal defect. Scanning electron microscopy (SEM) showed encouraging result where immature cilia were present on the surface of TEREC. This result indicates that engineered respiratory epithelium was able to function as normal tissue.

Matched MeSH terms: Respiratory System/cytology*
Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital

Raja NS, Singh NN

J Microbiol Immunol Infect, 2007 Feb;40(1):45-9.
PMID: 17332906

BACKGROUND AND PURPOSE: Pseudomonas aeruginosa is an important cause of morbidity and mortality in hospitalized, critically ill patients and patients with underlying medical conditions such as cystic fibrosis, neutropenia, and iatrogenic immunosuppression. The prevalence of multiresistant P. aeruginosa isolates has been increasing. The aim of this study was to determine the antimicrobial susceptibility patterns in P. aeruginosa strains isolated at a university teaching hospital in Kuala Lumpur, Malaysia.
METHODS: The Laboratory Information System of the microbiology department was retrospectively reviewed to determine the susceptibility patterns of P. aeruginosa isolates to anti-pseudomonal antibiotics, from January to June 2005. Disk diffusion methods were employed and results were interpreted according to National Committee for Clinical Laboratory Standards guidelines.
RESULTS: 505 clinical isolates of P. aeruginosa were tested. Major sources of these isolates included respiratory tract, wound, urine and blood. The rates of antimicrobial resistance of isolates were 6.73% to amikacin, 12.9% to gentamicin, 10.1% to netilmicin, 10.9% to ceftazidime, 11.3% to ciprofloxacin, 9.9% to imipenem, 10.8% to piperacillin, 9.4% to piperacillin-tazobactam and 0% to polymyxin B. Of the 505 isolates, 29 (5.74%) were found to be multidrug-resistant; these were most commonly isolated from respiratory tract specimens of patients in surgical units, followed by respiratory tract specimens in patients in medical units.
CONCLUSIONS: The data in this study showed low rates of antibiotic resistance among P. aeruginosa isolates. Combinations of aminoglycosides plus beta-lactams or quinolones should be the appropriate choice for empirical therapy in P. aeruginosa infections. Active antibiotic susceptibility testing and surveillance should be continued in order to curtail the problem of antibiotic resistance.

Matched MeSH terms: Respiratory System/microbiology
Challenges and future direction of molecular research in air pollution-related lung cancers

Shahadin MS, Ab Mutalib NS, Latif MT, Greene CM, Hassan T

Lung Cancer, 2018 04;118:69-75.
PMID: 29572006 DOI: 10.1016/j.lungcan.2018.01.016

Hazardous air pollutants or chemical release into the environment by a variety of natural and/or anthropogenic activities may give adverse effects to human health. Air pollutants such as sulphur dioxide (SO2), nitrogen oxides (NOx), carbon monoxide (CO), heavy metals and particulate matter (PM) affect number of different human organs, especially the respiratory system. The International Agency for Research on Cancer (IARC) reported that ambient air pollution is a cause of lung cancer. Recently, the agency has classified outdoor air pollution as well as PM air pollution as Group 1 carcinogens. In addition, several epidemiological studies have shown a positive association between air pollutants to lung cancer risks and mortality. However, there are only a few studies examining the molecular effects of air pollution exposure specifically in lung cancer due to multiple challenges to mimic air pollution exposure in basic experimentation. Another major issue is the lack of adequate adjustments for exposure misclassification as air pollution may differ temporo-spatially and socioeconomically. Thus, the purpose of this paper is to review the current molecular understanding of air pollution-related lung cancer and potential future direction in this challenging yet important research field.

Matched MeSH terms: Respiratory System/pathology*
Mucuna pruriens Linn. seed extract pretreatment protects against cardiorespiratory and neuromuscular depressant effects of Naja sputatrix (Javan spitting cobra) venom in rats

Fung SY, Tan NH, Sim SM, Marinello E, Guerranti R, Aguiyi JC

Indian J Exp Biol, 2011 Apr;49(4):254-9.
PMID: 21614888

Mucuna pruriens has been used by native Nigerians as a prophylactic for snakebite. The protective effects of M. pruriens seed extract (MPE) were investigated against the pharmacological actions of N. sputatrix (Javan spitting cobra) venom in rats. The results showed that MPE-pretreatment protected against cardiorespiratory and, to a lesser extent, neuromuscular depressant effects of N. sputatrix venom. These may be explained at least in part by the neutralisation of the cobra venom toxins by anti-MPE antibodies elicited by the MPE pretreatment.

Matched MeSH terms: Respiratory System/drug effects
Fulltext Protective effects of Mucuna pruriens seed extract pretreatment against cardiovascular and respiratory depressant effects of Calloselasma rhodostoma (Malayan pit viper) venom in rats

Fung SY, Tan NH, Sim SM

Trop Biomed, 2010 Dec;27(3):366-72.
PMID: 21399576 MyJurnal

The protective effects of Mucuna pruriens seed extract (MPE) against the cardio-respiratory depressant and neuromuscular paralytic effects induced by injection of Calloselasma rhodostoma (Malayan pit viper) venom in anaesthetized rats were investigated. While MPE pretreatment did not reverse the inhibitory effect of the venom on the gastrocnemius muscle excitability, it significantly attenuated the venom-induced cardio-respiratory depressant effects (p < 0.05). The protection effects may have an immunological mechanism, as indicated by the presence of several proteins in the venom that are immunoreactive against anti-MPE. However, we cannot rule out the possibility that the pretreatment may exert a direct, non-immunological protective action against the venom.

Matched MeSH terms: Respiratory System/drug effects
Fulltext Model-based PEEP titration versus standard practice in mechanical ventilation: a randomised controlled trial

Kim KT, Morton S, Howe S, Chiew YS, Knopp JL, Docherty P, et al.

Trials, 2020 Feb 01;21(1):130.
PMID: 32007099 DOI: 10.1186/s13063-019-4035-7

BACKGROUND: Positive end-expiratory pressure (PEEP) at minimum respiratory elastance during mechanical ventilation (MV) in patients with acute respiratory distress syndrome (ARDS) may improve patient care and outcome. The Clinical utilisation of respiratory elastance (CURE) trial is a two-arm, randomised controlled trial (RCT) investigating the performance of PEEP selected at an objective, model-based minimal respiratory system elastance in patients with ARDS.
METHODS AND DESIGN: The CURE RCT compares two groups of patients requiring invasive MV with a partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio ≤ 200; one criterion of the Berlin consensus definition of moderate (≤ 200) or severe (≤ 100) ARDS. All patients are ventilated using pressure controlled (bi-level) ventilation with tidal volume = 6-8 ml/kg. Patients randomised to the control group will have PEEP selected per standard practice (SPV). Patients randomised to the intervention will have PEEP selected based on a minimal elastance using a model-based computerised method. The CURE RCT is a single-centre trial in the intensive care unit (ICU) of Christchurch hospital, New Zealand, with a target sample size of 320 patients over a maximum of 3 years. The primary outcome is the area under the curve (AUC) ratio of arterial blood oxygenation to the fraction of inspired oxygen over time. Secondary outcomes include length of time of MV, ventilator-free days (VFD) up to 28 days, ICU and hospital length of stay, AUC of oxygen saturation (SpO2)/FiO2 during MV, number of desaturation events (SpO2

Matched MeSH terms: Respiratory System/physiopathology
The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Sharif-Abdullah SS, Chong MC, Surindar-Kaur SS, Kamaruzzaman SB, Ng KH

Singapore Med J, 2016 May;57(5):262-6.
PMID: 27211885 DOI: 10.11622/smedj.2016091

INTRODUCTION: Inadequate oral care has been implicated in the development of aspiration pneumonia in frail geriatric patients and is a major cause of mortality, due to the colonisation of microbes in vulnerable patients. This type of pneumonia has been associated with an increase in respiratory pathogens in the oral cavity. The aim of this study was to evaluate the effects of chlorhexidine compared to routine oral care in edentulous geriatric inpatients.
METHODS: A double-blind, parallel-group randomised controlled trial was carried out. The intervention group received oral care with chlorhexidine 0.2%, while the control group received routine oral care with thymol. Nurses provided oral care with assigned solutions of 20 mL once daily over seven days. Oral cavity assessment using the Brief Oral Health Status Examination form was performed before each oral care procedure. Data on medication received and the subsequent development of aspiration pneumonia was recorded. An oral swab was performed on Day 7 to obtain specimens to test for colonisation.
RESULTS: The final sample consisted of 35 (control) and 43 (intervention) patients. Chlorhexidine was effective in reducing oral colonisation compared to routine oral care with thymol (p < 0.001). The risk of oral bacterial colonisation was nearly three times higher in the thymol group compared to the chlorhexidine group.
CONCLUSION: The use of chlorhexidine 0.2% significantly reduced oral colonisation and is recommended as an easier and more cost-effective alternative for oral hygiene.

Matched MeSH terms: Respiratory System/microbiology
Fulltext Bilateral Jensen disease in a healthy young lady

Ghani Siti-Ilyana, Koh, Yi-Ni, Embong Zunaina

Journal of Biomedical and Clinical Sciences, 2018;3(1):19-24.
MyJurnal

Toxoplasmic optic neuropathy is rare and usually occurs monoocularly. This case report demonstrates a rare presentation of bilateral
juxtapapillary retinochoroiditis (Jensen disease) due to toxoplasma infection in
a young healthy patient. A 20-year-old lady presented with bilateral painless
blurring of central vision for 5 days duration. It was preceded by fever, upper
respiratory tract symptoms and headache. There was no history of contact or
being scratched by a cat. Visual acuity was counting fingers for the right eye
and 6/45 for the left eye. There was presence of relative afferent pupillary
defect in the right eye. Optic nerve functions were impaired bilaterally which
was severe in the right eye. Both eyes showed the presence of mild anterior
segment inflammation and vitritis. Fundus examination revealed juxtapapillary
retinochoroiditis bilaterally with swollen optic disc. Optical coherence
tomography (OCT) showed presence of intra-retinal and sub-retinal fluid at
macular area bilaterally. Serology for anti-toxoplasma Immunoglobulin G (IgG)
was positive with titre of 1450 IU/ml. Computed tomography scan (CT scan) of
brain and orbit was normal. A diagnosis of bilateral juxtapapillary
retinochoroiditis or Jensen disease was made. Oral azithromycin 500 mg daily
and guttae prednisolone 4 hourly for 6 weeks was commenced. Oral
prednisolone 50 mg daily (1 mg/kg/day) was added after completion of 1 week
of antibiotic and was tapered down within 5 weeks. There was improvement of
vision as early as 3 weeks post initiation of the treatment. Upon 6 weeks
completing the treatment, her vision has improved to 6/7.5 on both eyes with
resolution of optic disc swelling and sub-retinal fluid. Early recognition and
initiation of treatment in toxoplasma infection associated with juxtapapillary
retinochoroiditis usually result in good visual prognosis.

Matched MeSH terms: Respiratory System
Fulltext An Influenza A Vaccine Based on the Extracellular Domain of Matrix 2 Protein Protects BALB/C Mice Against H1N1 and H3N2

Ong HK, Yong CY, Tan WS, Yeap SK, Omar AR, Razak MA, et al.

Vaccines (Basel), 2019 08 19;7(3).
PMID: 31430965 DOI: 10.3390/vaccines7030091

Current seasonal influenza A virus (IAV) vaccines are strain-specific and require annual reconstitution to accommodate the viral mutations. Mismatches between the vaccines and circulating strains often lead to high morbidity. Hence, development of a universal influenza A vaccine targeting all IAV strains is urgently needed. In the present study, the protective efficacy and immune responses induced by the extracellular domain of Matrix 2 protein (M2e) displayed on the virus-like particles of Macrobrachium rosenbergii nodavirus (NvC-M2ex3) were investigated in BALB/c mice. NvC-M2ex3 was demonstrated to be highly immunogenic even in the absence of adjuvants. Higher anti-M2e antibody titers corresponded well with increased survival, reduced immunopathology, and morbidity of the infected BALB/c mice. The mice immunized with NvC-M2ex3 exhibited lower H1N1 and H3N2 virus replication in the respiratory tract and the vaccine activated the production of different antiviral cytokines when they were challenged with H1N1 and H3N2. Collectively, these results suggest that NvC-M2ex3 could be a potential universal influenza A vaccine.

Matched MeSH terms: Respiratory System
Fulltext Dust exposure and respiratory health of workers in a steel mill in Terengganu, Malaysia

Nurul Ainun Hamzah, Shamsul Bahri Mohd Tamrin, Noor Hassim Ismail

Journal of Occupational Safety and Health, 2018;15(1):1-16.
MyJurnal

Air pollution in steel making operations effect to respiratory health. This study aimed to measure the dust exposure and evaluate the respiratory health among steel workers. A cross sectional study was conducted among 402 male workers. Respiratory symptoms using British Medical Research Council (BMRC) Questionnaire while lung function was measured The airborne dust [PM2.5, PM10, and Total Particulate Matter (TPM)] were monitored by Handheld 3016 Counter. All the parameters studied exceeded the limit of Malaysian guideline standard. Prevalence of chronic phlegm, chest of tightness, and shortness of breath were 35.8 %, 32.8 %, 23.4 %, and 22.4 %, respectively. significant differences between shortness of breath and work section (2=9.236, p=0.026) and %FEV1/FVC with work section [F (3, 3.98=3.194), p=0.025]. Smoking was associated with chronic cough (Adj OR =1.07, 95% CI: phlegm (Adj OR =1.05, 95% CI: 1.03 - 1.08), and shortness of breath (Adj OR = 1.05, 95% CI: 1.00 past respiratory illnesses was associated with chest tightness (Adj OR = 2.24, 95% CI: 1.04 - 4.84) and (Adj OR = 4.16, 95% CI: 1.92 - 9.92). Duration of employment was associated with FEV1 (β=-0.025, 0.020) while past respiratory illnesses was associated with %FEV1/FVC (β =-1.784, 95% CI: -3.017 workers are at risk of developing respiratory symptoms and lung function impairment.

Matched MeSH terms: Respiratory System
Emerging concepts and directed therapeutics for the management of asthma: regulating the regulators

Shastri MD, Chong WC, Dua K, Peterson GM, Patel RP, Mahmood MQ, et al.

Inflammopharmacology, 2021 Feb;29(1):15-33.
PMID: 33152094 DOI: 10.1007/s10787-020-00770-y

Asthma is a common, heterogeneous and serious disease, its prevalence has steadily risen in most parts of the world, and the condition is often inadequately controlled in many patients. Hence, there is a major need for new therapeutic approaches. Mild-to-moderate asthma is considered a T-helper cell type-2-mediated inflammatory disorder that develops due to abnormal immune responses to otherwise innocuous allergens. Prolonged exposure to allergens and persistent inflammation results in myofibroblast infiltration and airway remodelling with mucus hypersecretion, airway smooth muscle hypertrophy, and excess collagen deposition. The airways become hyper-responsive to provocation resulting in the characteristic wheezing and obstructed airflow experienced by patients. Extensive research has progressed the understanding of the underlying mechanisms and the development of new treatments for the management of asthma. Here, we review the basis of the disease, covering new areas such as the role of vascularisation and microRNAs, as well as associated potential therapeutic interventions utilising reports from animal and human studies. We also cover novel drug delivery strategies that are being developed to enhance therapeutic efficacy and patient compliance. Potential avenues to explore to improve the future of asthma management are highlighted.

Matched MeSH terms: Respiratory System
Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis Respiratory Colonization in Malaysian Preterm Infants

Ng KF, Kee Tan K, Chok MC, Zamil Mohd Muzzamil N, Choo P, Paramasivam U, et al.

J Trop Pediatr, 2017 Dec 01;63(6):447-453.
PMID: 28334949 DOI: 10.1093/tropej/fmx011

This prospective observational study aims to determine the incidence, predictors and clinical features of Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) respiratory colonization in infants <37 weeks of gestation. A total of 200 preterm newborns admitted to a tertiary center in Malaysia between 2013 and 2015 for increased breathing effort had their respiratory secretions tested for these bacteria by polymerase chain reaction. Fifteen of the 200 (7.5%) infants were detected to have these organisms in their respiratory tracts. Preterm prelabor rupture of membrane was associated with positive detection (odds ratio: 3.7; 95% confidence interval: 1.2-11.3). Seventy-three of the 200 (36.5%) infants were given macrolide for presumed infection but only 4.1% (3 of 73) were positive for these organisms. The incidence of UU respiratory colonization among preterm infants in our center is lower than other published reports, while the frequency of MH and CT isolation is comparable with many studies. There should be judicious use of empirical antibiotics for presumed UU, MH and CT infection in preterm infants.

Matched MeSH terms: Respiratory System
The relationship between Kuala Lumpur haze and asthmatic attacks in children

Zailina Hashim, Juliana Jalaludin, Norzila Muhamad Zainudin, Azizi Omar, Jamal H. Hashim

Malaysian Journal of Child Health, 1997;9(2):151-159.
MyJurnal

A study on 30 asthmatic children was conducted in Kuala Lumpur. The objective of this study was to study the relationship between respirable particulate (PM10), sulphur dioxide, ozone and various meteorological factors such as humidity, level ofrainfall and temperature with asthma attacks. This study was conducted from 1st September to 31 December 1994. Patients were selected from the Paediatric Unit, Kuala Lumpur Hospital. Questionnaires were used to obtain information from their parents on the history and severity ofasthmatic attacks ofthese patients. Questionnaires were also used to determine if the indoor sources contributed to the attack. Diary cards were used to collect information on the frequency of asthmatic attacks. Each patient's progress was followed through every week during the study period and the attacks were recorded. The data on air quality on the PM10, sulphur dioxide, nitrogen dioxide, carbon monoxide and ozone were collected hourly using the microcomputer system of air monitoring unit from the Universiti Pertanian Malaysia air quality monitoring station located at the City Hall, Kuala Lumpur. The meteorological parameters such as temperature, relative humidity and rain-fall levels were also monitored daily. The asthmatic attack percentage was obtained by dividing the number of attacks in a day with the total number of sample and multiplying by a hundred. Statistical tests indicated that there was a significant correlation between asthmatic attacks and the PM10 concentrations (r=0.73), nitrogen dioxide (r=0.57) and.carbon monoxide (r=0.53) throughout the study period. During the haze episode, more significant correlations between asthmatic attacks, PM10 concentra-tions (0.86), carbon monoxide (0.79) and nitrogen oxide (0.53) were found. Multiple regression statistical test showed that PM10 had the greatest influence on the asthmatic attack rate. The minute respirable particulate which entered the respiratory system of the asthmatics triggered attacks on these patients.

Matched MeSH terms: Respiratory System
Fulltext Fatal melioidosis in a captive elephant trunk snake (Acrochordus javanicus) in Kuala Lumpur, Malaysia

Sadiq, M.A., Zakaria, Z., Saharee, A.A., Abba, Y., Hassan, L.

Jurnal Veterinar Malaysia, 2016;28(1):20-26.
MyJurnal

An adult female Elephant Trunk Snake (Acrochordus javanicus) was reported to have been weak and inappetent for five days. The following morning the snake found dead, while in the process of shedding its skin. On post mortem examination, there were multiple circumscribed caseous nodules of various sizes distributed all over the liver, along the respiratory tract and on the lungs. Bacteriological analysis of the lungs and liver swab samples yielded Burkholderia pseudomallei, which was confirmed by PCR amplification of specific 16S rRNA. The condition was diagnosed as melioidosis and the organism was genotypically characterized as sequence type 51, a genotype that has been previously characterized in humans in Malaysia. Antibiotic susceptibility by both Disc diffusion or Kirby Bauer and E-test minimum inhibitory concentration (MIC) showed that the organism exhibited susceptibility to meropenem, imipenem, ceftazidime, cotrimoxazole and co-amoxyclav; the antibiotics recommended in the treatment of melioidosis.

Matched MeSH terms: Respiratory System
Airborne particles in the city center of Kuala Lumpur: Origin, potential driving factors, and deposition flux in human respiratory airways

Khan MF, Hamid AH, Bari MA, Tajudin ABA, Latif MT, Nadzir MSM, et al.

Sci Total Environ, 2019 Feb 10;650(Pt 1):1195-1206.
PMID: 30308807 DOI: 10.1016/j.scitotenv.2018.09.072

Equatorial warming conditions in urban areas can influence the particle number concentrations (PNCs), but studies assessing such factors are limited. The aim of this study was to evaluate the level of size-resolved PNCs, their potential deposition rate in the human respiratory system, and probable local and transboundary inputs of PNCs in Kuala Lumpur. Particle size distributions of a 0.34 to 9.02 μm optical-equivalent size range were monitored at a frequency of 60 s between December 2016 and January 2017 using an optical-based compact scanning mobility particle sizer (SMPS). Diurnal and correlation analysis showed that traffic emissions and meteorological confounding factors were potential driving factors for changes in the PNCs (Dp ≤1 μm) at the modeling site. Trajectory modeling showed that a PNC <100/cm3 was influenced mainly by Indo-China region air masses. On the other hand, a PNC >100/cm3 was influenced by air masses originating from the Indian Ocean and Indochina regions. Receptor models extracted five potential sources of PNCs: industrial emissions, transportation, aged traffic emissions, miscellaneous sources, and a source of secondary origin coupled with meteorological factors. A respiratory deposition model for male and female receptors predicted that the deposition flux of PM1 (particle mass ≤1 μm) into the alveolar (AL) region was higher (0.30 and 0.25 μg/h, respectively) than the upper airway (UA) (0.29 and 0.24 μg/h, respectively) and tracheobronchial (TB) regions (0.02 μg/h for each). However, the PM2.5 deposition flux was higher in the UA (2.02 and 1.68 μg/h, respectively) than in the TB (0.18 and 0.15 μg/h, respectively) and the AL regions (1.09 and 0.91 μg/h, respectively); a similar pattern was also observed for PM10.

Matched MeSH terms: Respiratory System
Fulltext Paediatric and adult bronchiectasis: Monitoring, cross-infection, role of multidisciplinary teams and self-management plans

Navaratnam V, Forrester DL, Eg KP, Chang AB

Respirology, 2019 02;24(2):115-126.
PMID: 30500093 DOI: 10.1111/resp.13451

Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi, clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimize further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (forced expiratory volume in 1 s (FEV1 )% predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with Pseudomonas aeruginosa). There is good evidence that these monitoring tools can be used to accurately assess severity of disease and predict prognosis in terms of mortality and future hospitalization. Other tools that are currently used in research settings such as health-related quality of life (QoL) questionnaires, magnetic resonance imaging and lung clearance index can be burdensome and require additional expertise or resource, which limits their use in clinical practice. Studies have demonstrated that cross-infection, especially with P. aeruginosa between patients with bronchiectasis is possible but infrequent. This should not limit participation of patients in group activities such as pulmonary rehabilitation, and simple infection control measures should be carried out to limit the risk of cross-transmission. A multidisciplinary approach to care which includes respiratory physicians, chest physiotherapists, nurse specialists and other allied health professionals are vital in providing holistic care. Patient education and personalized self-management plans are also important despite limited evidence it improves QoL or frequency of exacerbations.

Matched MeSH terms: Diagnostic Techniques, Respiratory System

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